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Physical, occupational, and speech therapy for children with cerebral palsy
Author(s) -
McCoy Sarah Westcott,
Palisano Robert,
Avery Lisa,
Jeffries Lynn,
Laforme Fiss Alyssa,
Chiarello Lisa,
Hanna Steve
Publication year - 2020
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14325
Subject(s) - cerebral palsy , recreation , occupational therapy , rehabilitation , psychology , gross motor skill , physical therapy , inclusion (mineral) , medicine , clinical psychology , physical medicine and rehabilitation , developmental psychology , motor skill , social psychology , political science , law
Aim To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP). Method We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo–11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children’s performance in self‐care and participation in recreation. Therapists and parents collaboratively classified children’s Gross Motor Function Classification System (GMFCS) levels. We created longitudinal graphs for each GMFCS level, depicting change across time using centiles. Using multinomial models, we analyzed the relationship between therapies (amount, focus, family‐centeredness, and the extent therapies met children’s needs) and whether change in balance, walking endurance, and participation was ‘more than’ and ‘less than’ the reference of ‘as expected’. Results Children were more likely to progress ‘more than expected’ when participating in recreation when therapies were family‐centered, met children’s needs, and focused on structured play/recreation. A focus on health and well‐being was positively associated with participation and self‐care. The amount of therapy did not predict outcomes. Interpretation Therapy services that are family‐centered, consider the needs of the child, and focus on structured play/recreational activities and health/well‐being may enhance the development of children with CP. What this paper adds Family‐centered rehabilitation therapies were positively associated with greater participation in family/recreation activities and walking endurance. Parental perception that rehabilitation therapies met children’s needs was associated with greater participation in family/recreation activities. Structured play, recreational activities, and health/well‐being are important for self‐care and participation when planning rehabilitation therapy. The amount of rehabilitation therapy was not related to developmental outcomes.